From the Research
Treatment for sperm granuloma typically involves conservative management as these lesions often resolve on their own. Initial treatment includes pain management with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily) for 1-2 weeks to reduce inflammation and discomfort 1. Applying cold compresses to the affected area for 15-20 minutes several times daily can help reduce swelling. Rest and scrotal support using athletic supporters or tight underwear may provide relief by minimizing movement and irritation. For persistent or severe cases, a spermatic cord block with local anesthetics like lidocaine may be performed. Antibiotics are generally not necessary unless there's evidence of infection. In rare cases where conservative measures fail and pain is severe or persistent, surgical excision of the granuloma may be considered, as seen in a case report where a 46-year-old man underwent surgical resection of bilateral sperm granulomas 1. Sperm granulomas develop as an inflammatory reaction to sperm leakage into surrounding tissues, often following vasectomy or other trauma to the male reproductive tract, and the body's immune system responds to the sperm as foreign material, creating these nodules.
Some key points to consider in the treatment of sperm granuloma include:
- Conservative management is often sufficient, with most lesions resolving on their own
- Pain management with NSAIDs and cold compresses can help reduce discomfort and swelling
- Rest and scrotal support can provide relief by minimizing movement and irritation
- Surgical excision may be considered in rare cases where conservative measures fail and pain is severe or persistent
- Sperm granulomas can be distinguished from other conditions, such as epididymal tuberculosis and chronic epididymitis, through postoperative histopathological and immunohistochemical examination 1.
It's worth noting that while there are various case reports and studies on sperm granuloma, the most recent and highest quality study 1 provides the most relevant guidance on treatment and management.